Download CASE SCENARIORS

Role-play_ Unit 1_Clinical Assessment
Role play Exercise for participants
• For this exercise you will be assigned the role of
1. Patient
2. Nurse
3. Doctor
4. Pharmacist
1. As a patient you go to clinic since you are feeling unwell and sneezing. As a
patient go to the pharmacy and demand for Amoxicillin (antibiotic) from the
pharmacist when the doctor sends you to the pharmacy
2. As a nurse assess all the vitals of the patient and send the patient to doctor for
possible diagnosis
3. As a doctor, clinically examine the patient and come up with a diagnosis
4. You assess the patient and find that she is suffering from a flu
5. As doctor prescribe some lozenges to be collected from the pharmacy
6. After prescribing send the patient sent to pharmacy to collect lozenges
7. As a pharmacist educate the patient that there is no need for antibiotic use in
this case
Discuss out issues of inappropriate use, rational use and antimicrobial stewardship
B. Game_ Unit 2_ Rational Use of Antimicrobial Agents
As participants in groups assigned by the facilitator, do this exercise.

The facilitator will give you the board game

The game has questions and possible answers on the cards

One member of your group picks a question by way of rolling the dice to be
answered
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The number on the rolled dice corresponds to the question to be picked

The opponent group member for the group you are playing with provides the
answer to question by making two attempts only
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The correct answer is read by the member who picked the question to
determine whether the answer provided is correct
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Correct answer scores 3 points and wrong answer 0 score

Record the score(s) on the score board
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As participants you continue to play the game until there is a winner within 15
minutes
C. Quiz_ Critical Thinking
1. What is the main role of pharmacists in AMS?
2. Give examples of how nurses can promote appropriate use of antimicrobials
3. Give examples of inappropriate use of antimicrobials
D. Quiz_ Unit 4
State whether the statement is TRUE or FALSE:
1. Antimicrobial agents are required to be selectively toxic to the pathogenic
microorganism and relatively nontoxic to the host cells
2. Monotherapy does not reduce chances of drug-drug interactions & toxicity
resulting from use of multiple drugs
3. Choice of antibiotic should be based on appropriate clinical diagnosis,
microbiological identification of the pathogenic species, and antimicrobial
sensitivity pattern of the organism
4. Reaching men is not critical to STD prevention programs as long as women are
provided with services
5. STD management includes laboratory-based, clinical (without laboratory
support) and syndromic approaches
E. Case Study_ Unit 5_ Case Scenarios
CASE 1
AB is a 72-year-old post-menopausal woman found confused by her family and
hospitalized with a urinary tract infection.
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PMH: Diabetes, HTN, CKD stage 3, Atrial fibrillation

She is prescribed ceftriaxone 1gm IV q24h and you evaluate her on day 3
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VS:142/94 mmHg, T=37.2oC, HR=84bp/m, RR=16bp/m
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Patient feels well and is ready to go home

Urine culture: >100,000 CFU/mL E. coli
Questions
1. What phase of therapy are we looking at – prophylactic, empiric, or definitive?
2. What are the antimicrobial treatment options for this patient?
3. What is your choice of therapy? Why?
CASE 2
DE is a 21-year-old male college learner admitted to the emergency department with
presumed meningitis.

VS:112/82mmHg T=39.3oC HR=110bpm RR=16bpm
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PMH: None

Day 1: Empiric Selection
Questions:
1. What organisms would you expect to be the cause of this patient’s infection?
2. What are the treatment options for this patient?
3. What is your choice of therapy? Why?
Cultures from the CSF are obtained and are resulted on Day 3
Questions:
1. What is your choice of therapy? Why?
2. Would you transition him to PO meds as he improves?
3. How will you monitor him?
CASE 3
AG is a 45-year-old male who originally presented to the emergency department (ED)
complaining of progressive left arm pain and redness over the last week. He was last
admitted to the hospital three weeks ago, at which time he was diagnosed with
community-acquired pneumonia and treated with 5 days of antibiotics. The ED team
noted a 2 cm x 3 cm cutaneous abscess on his left forearm, which they drained 3 mL
of pus from and sent for culture. The patient was started on cefazolin 1,000 mg IV q8
hour and the team asks you to assist in this patient’s management.
• VS: BP = 122/72mmHg, T=37.2oC, HR=72bpm, RR=16bpm
Day 1:
1. What organisms would you expect to be the cause of this patient’s infection?
2. Do you agree with the therapy that was started for AG? Why or Why not?
3. AG is clinically stable and ready for discharge. Below is the hospital antibiogram
showing percentage susceptibility. The medical officer wants to empirically
prescribe clindamycin 450mg PO TID. Do you agree with this recommendation?
If not, what therapy would you recommend?